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Uncontrolled high blood pressure, by itself, makes both heart failure and heart attacks much more difficult to manage. Should they occur, controlling the high blood pressure is an early step toward managing these complications.
You can avoid or eliminate some risk factors, and some factors you can't avoid. Doing everything possible to avoid those you can helps to prevent these complications of high blood pressure and minimize their impact should they occur. The major risk factor that you can't change is a family history of early heart disease. Your choices, however, can affect the remaining factors.
High cholesterol
Half of the U.S. adult population has abnormally high cholesterol levels. These statistics are similar for the United Kingdom, Australia, and New Zealand. For a breakdown of the various ethnic populations, the rates are
- Caucasian: 52 percent of men and 49 percent of women
- African American: 45 percent of men and 46 percent of women
- Hispanic: 53 percent of men and 48 percent of women
- Native American: 38 percent of men and 37 percent of women
These high numbers suggest that complications, especially heart attacks in association with high blood pressure, are commonplace. Fortunately, high cholesterol is treatable. High cholesterol that doesn't respond to diet and exercise is easily managed by a group of drugs called "statins," a powerful group of cholesterol-lowering drugs.
 | Find out the level of your cholesterol and bring it down. The lower your cholesterol, the better. |
Tobacco use
In many ways, tobacco use is a greater problem than high cholesterol. The most important reason is that you're addicted to cigarettes, but you're not addicted to fat. Breaking the smoking habit is difficult but definitely worth doing.
About a quarter of the U.S. population is addicted to cigarette smoking. The ethnic breakdown is
- Caucasian: 26 percent of men and 24 percent of women smoke
- African American: 29 percent of men and 21 percent of women smoke
- Hispanic: 25 percent of men and 13 percent of women smoke
- Native American: 42 percent of men and 38 percent of women smoke
Just how many men and women continue to commit slow suicide is astonishing. Even more astonishing is the rate of cigarette smoking among young people who are very much aware of the statistics that relate cigarettes not only to heart disease, but to lung cancer, emphysema, and many other cancers.
Controlling diabetes
Now, more than 16 million Americans have diabetes. Heart attacks remain the most frequent cause of death among diabetics. Heart attacks are responsible for two-thirds of all deaths among diabetics. When they have heart attacks, they tend to be more complicated than a heart attack in a nondiabetic. The extensive nature of the atherosclerotic plaque (areas of obstruction in blood vessels) in diabetics results in a poor response to PTCA (percutaneous transluminal coronary angioplasty) and the need for CABG (coronary artery bypass graft) when angina or a heart attack occurs.
The prognosis is less pessimistic when the diabetes is brought under control. This means keeping the blood glucose (sugar) as close to the normal range as possible (between 80 and 120 milligrams of glucose per deciliter of blood) and keeping the hemoglobin A1c, a test for long-term diabetic control, under 7 percent of the total hemoglobin.
Diabetes is diagnosed when the blood glucose is 126 milligrams per deciliter (mg/dL) on two or more occasions in the fasting state or 200 mg/dL in a random blood glucose test on two or more occasions. The problem is that the increased risk of heart disease doesn't start when the blood glucose is over 126 fasting or 200 random. Between 110 and 126 in the fasting state or 140 and 200 at random, the patient is said to have impaired fasting glucose or impaired glucose tolerance. The increased risk of heart disease associated with the blood glucose is present at these levels of blood glucose as well. The number of people with these conditions isn't small. The statistics just for impaired fasting glucose are
- Caucasian: 9 percent of men and 5 percent of women
- African American: 3 percent of men and 5 percent of women
- Hispanic: 12 percent of men and 7 percent of women
The solution is to keep your weight down, get plenty of exercise, avoid fats, and keep your blood glucose under 110 fasting or 140 random. That keeps your heart risk at a minimum.
Lack of physical activity
Lack of physical activity has clearly been shown to be a risk factor for heart disease. Many people do work that requires little physical activity and exercise is needed during leisure time. This isn't happening, however. The following percentages show the populations that are sedentary:
- Caucasian: 33 percent of men and 39 percent of women
- African American: 46 percent of men and 57 percent of women
- Hispanic: 50 percent of men and 57 percent of women
 | Anyone who says that Americans are on the move hasn't looked at these numbers. The bottom line: The farther you walk, the longer you live. It's as simple as that. |
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